Samuel K. Jr.. Cohn. The Black Death Transformed: Disease and Culture in Early Renaissance Europe.
London: Edward Arnold Publishers, 2002. x + 318 pp. ISBN 978-0-340-70647-3. ISBN 978-0-340-70646-6.
Reviewed by Mary A. Valante.
Published on H-W-Civ (July, 2003).
The Black Death Untransformed
The Black Death Untransformed
“The Black Death in Europe, 1347-52, and its suc-
cessive waves to the eighteenth century was any dis-
ease other than the rat-based bubonic plague (now
known as Yersinia pestis), whose bacillus was discov-
ered in 1894” (p. 1). Thus opens Samuel Cohn’s The
Black Death Transformed. The author’s stated goal is
to re-read the late medieval European sources and to
show that they do not, in fact, describe the disease
known to our modern medical establishment as the
bubonic plague. Cohn deliberately makes no attempt
to offer another disease in place of the plague; the
entire book is dedicated simply to proving that the
Black Death was not the plague. From the start there
are some very basic problems with Cohn’s approach
to his topic. He uses only written sources from Eu-
rope, and while he alludes briefly to art history, Ara-
bic sources, and modern scientific investigation, none
is given much credence, especially where they might
disprove his thesis. Even his use of written sources
must be questioned when, for example, the extremely
important treatise of Guy de Chauliac (who recog-
nized two variants of the disease he saw, one causing
buboes and the other infecting the lungs), is cited
only from nineteenth-century translations rather than
from Michael McVaugh’s 1997 study.
In part 1, “The Middle Ages Confronts the Twen-
tieth Century,” Cohn argues that the medieval dis-
ease, as described by medieval authors, does not
match the known modern disease. The modern
plague does not spread nearly as quickly as the me-
dieval disease, even in its pneumonic form, and the
modern disease is far less fatal, even in terrible con-
ditions such as India. Cohn therefore accuses histo-
rians, who have argued the disease was the plague,
of abusing their sources and reading into them evi-
dence which does not exist. But comparing modern
outbreaks of a disease with a medieval epidemic is
1
fraught with problems that Cohn does not address.
For example, to what extent and in what ways is any
fourteenth-century city similar to modern China or
India? Cohn never establishes a firm basis for his
comparisons. Furthermore, the Center for Disease
Control reports that if the bubonic plague is left un-
treated, even today, it is more than 50 percent fatal.
In part 2, “Signs and Symptoms,” Cohn focuses
on the buboes and the spread of “pustules” or “spots”
described by some medieval authors. Primary sources
often describe the buboes as appearing on the neck
or armpit, as well as on the groin, though today vic-
tims may be more likely to show the buboes only in
the groin. As Cohn explains, since flea bites tend to
appear no higher than a person’s ankles, the groin is
the nearest lymph node that could be effected. But
people in the Middle Ages lived and interacted with
animals and pests far differently than we do today,
so why should we expect the transmission of fleas
to be similar? Even more troubling, Cohn has al-
most completely neglected artistic studies of plague
victims, most obviously the iconography of St Roche,
where there are numerous depictions of buboes in the
groin. The second symptom, “pustules” or “spots,” is
not associated with the plague in modern times. But
Cohn has at the least overstated the appearance of
this symptom, since the sources themselves are far
more vague than he would have us believe in describ-
ing what may or may not be the same symptom.
In part 3, “Epidemiology,” Cohn discusses the
speed with which the medieval disease spread, the
brief incubation period (as viewed through the pri-
mary sources), and the speed with which it killed. It
is only the first that truly can be used to argue against
the bubonic plague as a cause of the Black Death, and
even then only if one assumes a disease would spread
through a population in the Middle Ages in the same
 H-Net Reviews

manner it would today. Untreated, the disease to-
day kills nearly as quickly as medieval sources note.
As for the next two points, since observers in the past
could not know that the incubation period for the dis-
ease began with a flea bite, they must be unreliable
on that point. Cohn does point out that there is no
mention of a great mortality of rats or other flea hosts
in the primary sources. But Arabic sources describe
in great detail the deaths of the hosts for disease-
carrying fleas, as well as the deaths of wild and then
domesticated animals before the Black Death spread
to humans. Cohn does cite Michael Dols’s work on
other occasions in his text, but not here, where it
clearly belongs.
Cohn goes on to argue that the medieval Black
Death was at its peak in Italy in the summer and
farther north in the fall, when fleas should have been
dead. However, once again he again assumes that me-
dieval people were living and interacting with animals
and pests just as we do today. Worse, he utterly fails
to discuss the “Little Ice Age” and its impact on tem-
peratures and climate during the fourteenth century.
In his conclusion, Cohn clearly states that “[i]n
place of Yersinia pestis I offer no alternatives” (p.
247). He is entirely dismissive of DNA evidence from
southern France, where three bodies from a single
mass grave (not two bodies from different graves as
Cohn states) were tested for the presence of bubonic
plague and other possible causes of the Black Death,
including anthrax. Only the plague bacillus was dis-
covered by the “suicide DNA” tests, tests that elimi-
nate the possibility of contamination Cohn alludes to.
He finally concludes, “This book has sought to liber-
ate the Black Death from the late nineteenth-century
prison of that era’s bubonic plague and, in so doing,
to give grounding for a new history of disease and
culture in the West. By looking at the Black Death
afresh I have sought to solve a fundamental enigma
of the early Renaissance: why did a new culture of
’fame and glory’ spring forth from the West’s most
monumental mortality?” (p. 252). Cohn actually
spends only a few pages discussing the latter, so to
equate this portion of his work with his larger thesis
is misleading. Needless to say, in just a few pages
Cohn can hardly “solve a fundamental enigma of the
early Renaissance.”
Cohn’s arguments rely far too heavily on underly-
ing assumptions that medieval people lived like mod-
ern people. His narrow focus on written European
sources is another serious methodological weakness.
Although he does raise some important questions, the
book is too unreliable in its presentation of evidence
and too dismissive of evidence that does not fit his
thesis to be a serious contribution to the study of the
Black Death.

Citation: Mary A. Valante. Review of Cohn, Samuel K. Jr.., Black Death Transformed: Disease and
Culture in Early Renaissance Europe, The. H-W-Civ, H-Net Reviews. July, 2003.
URL: http://www.h-net.org/reviews/showrev.php?id=7939

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